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Neurofilament light chain associates with IVH and ROP in extremely preterm infants

Sjöbom, Ulrika ; Öhrfelt, Annika ; Pivodic, Aldina ; Nilsson, Anders K. ; Blennow, Kaj ; Zetterberg, Henrik ; Hellström, William ; Danielsson, Hanna ; Gränse, Lotta LU orcid and Sävman, Karin , et al. (2024) In Pediatric Research
Abstract

Background: Neurofilament light chain (NfL) is known for indicating adult brain injury, but the role of NfL in extremely preterm infants is less studied. This study examines the relationship between NfL and neurovascular morbidities in these infants. Methods: A secondary analysis of the Mega Donna Mega trial was conducted on preterm infants <28 weeks gestational age (GA). The study measured NfL levels and proteomic profiles related to the blood-brain barrier in serum from birth to term-equivalent age, investigating the association of NfL with GA, retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and blood-brain barrier proteins. Results: Higher NfL levels were seen in the first month in infants with severe IVH and... (More)

Background: Neurofilament light chain (NfL) is known for indicating adult brain injury, but the role of NfL in extremely preterm infants is less studied. This study examines the relationship between NfL and neurovascular morbidities in these infants. Methods: A secondary analysis of the Mega Donna Mega trial was conducted on preterm infants <28 weeks gestational age (GA). The study measured NfL levels and proteomic profiles related to the blood-brain barrier in serum from birth to term-equivalent age, investigating the association of NfL with GA, retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and blood-brain barrier proteins. Results: Higher NfL levels were seen in the first month in infants with severe IVH and for those born <25 weeks GA (independent of ROP or IVH). Additionally, infants born at 25–27 weeks GA with high NfL were at increased risk of developing severe ROP (independent of IVH). NfL was significantly associated with the proteins CDH5, ITGB1, and JAM-A during the first month. Conclusion: NfL surges after birth in extremely preterm infants, particularly in those with severe IVH and ROP, and in the most immature infants regardless of IVH or ROP severity. These findings suggest NfL as a potential predictor of neonatal morbidities, warranting further validation studies. Impact statement: This study shows that higher NfL levels are related to neurovascular morbidities in extremely preterm infants. The degree of immaturity seems important as infants born <25 weeks gestational age exhibited high postnatal serum NfL levels irrespective of neurovascular morbidities. Our findings suggest a potential link between NfL and neurovascular morbidities possibly affected by a more permeable blood-brain barrier.

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Contribution to journal
publication status
epub
subject
in
Pediatric Research
publisher
International Pediatric Foundation Inc.
external identifiers
  • pmid:39317698
  • scopus:85204801631
ISSN
0031-3998
DOI
10.1038/s41390-024-03587-5
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2024.
id
04ce08d0-a4bd-43c3-ac18-f006aeba984a
date added to LUP
2024-11-26 14:50:57
date last changed
2025-07-09 09:30:36
@article{04ce08d0-a4bd-43c3-ac18-f006aeba984a,
  abstract     = {{<p>Background: Neurofilament light chain (NfL) is known for indicating adult brain injury, but the role of NfL in extremely preterm infants is less studied. This study examines the relationship between NfL and neurovascular morbidities in these infants. Methods: A secondary analysis of the Mega Donna Mega trial was conducted on preterm infants &lt;28 weeks gestational age (GA). The study measured NfL levels and proteomic profiles related to the blood-brain barrier in serum from birth to term-equivalent age, investigating the association of NfL with GA, retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and blood-brain barrier proteins. Results: Higher NfL levels were seen in the first month in infants with severe IVH and for those born &lt;25 weeks GA (independent of ROP or IVH). Additionally, infants born at 25–27 weeks GA with high NfL were at increased risk of developing severe ROP (independent of IVH). NfL was significantly associated with the proteins CDH5, ITGB1, and JAM-A during the first month. Conclusion: NfL surges after birth in extremely preterm infants, particularly in those with severe IVH and ROP, and in the most immature infants regardless of IVH or ROP severity. These findings suggest NfL as a potential predictor of neonatal morbidities, warranting further validation studies. Impact statement: This study shows that higher NfL levels are related to neurovascular morbidities in extremely preterm infants. The degree of immaturity seems important as infants born &lt;25 weeks gestational age exhibited high postnatal serum NfL levels irrespective of neurovascular morbidities. Our findings suggest a potential link between NfL and neurovascular morbidities possibly affected by a more permeable blood-brain barrier.</p>}},
  author       = {{Sjöbom, Ulrika and Öhrfelt, Annika and Pivodic, Aldina and Nilsson, Anders K. and Blennow, Kaj and Zetterberg, Henrik and Hellström, William and Danielsson, Hanna and Gränse, Lotta and Sävman, Karin and Wackernagel, Dirk and Hansen-Pupp, Ingrid and Ley, David and Hellström, Ann and Löfqvist, Chatarina}},
  issn         = {{0031-3998}},
  language     = {{eng}},
  publisher    = {{International Pediatric Foundation Inc.}},
  series       = {{Pediatric Research}},
  title        = {{Neurofilament light chain associates with IVH and ROP in extremely preterm infants}},
  url          = {{http://dx.doi.org/10.1038/s41390-024-03587-5}},
  doi          = {{10.1038/s41390-024-03587-5}},
  year         = {{2024}},
}